Dutch Courage and Dopamine Deficits: The Neurodivergent Addiction Trap

How undiagnosed neurodiversity fuels addiction, with a special mention for alcohol

Author illustration

There’s a moment many late-diagnosed neurodivergent people describe, a lightning bolt of realization: Wait—this is me? It often comes after years of feeling like a faulty human, of wondering why life seems easier for everyone else. For many, it comes after years of self-medicating with alcohol because that’s the only way you’re ever getting them to attend any group-based social event.

A generation lost in the grey area

For decades, neurodiversity - conditions like ADHD, Autism, and other cognitive differences - was largely misunderstood. If you weren’t a hyperactive boy disrupting class or the non-verbal child needing intensive support, you were basically ‘fine.’ You were a chatterbox. A daydreamer. Too sensitive. Too intense. Too much. A bit weird, maybe. But ok. Not too much trouble, in other words.

But many of us weren’t fine. We were struggling, exhausted by the effort it took to act normal. (Which, honestly, was never that convincing anyway.) And when that effort became unbearable, we found something that took the edge off: alcohol. Lovely, delicious, socially-sanctioned alcohol.

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The case for alcohol.

Alcohol is the world’s most socially acceptable coping mechanism. Drink to relax? That’s just unwinding. Drink to manage social anxiety? That’s the cost of being the life of the party. Drink to feel okay in your own skin - well, so does everyone, right? Right?! (Insert nervous laughter here.)

And that’s part of what makes addiction so slippery. It hides inside regular behaviours - Dutch courage, unwinding after work, celebrating with friends. Just like neurodivergence hides inside regular behaviours - everyone forgets their keys sometimes, everyone gets distracted, everyone zones out during long conversations, most people wish to avoid life’s more boring tasks. The problem isn’t the behaviour itself; it’s the frequency, intensity, and function of it. But how do you measure that? Where’s the line? Who gets to decide when drinking to calm your nerves is a warning sign, and when it’s just what people do?

Dr Laura Hull, Dr Felicity Sedgewick and Helen Ellis published a book all about exactly this, which I’m currently reading as part of research for my upcoming book, and will write more about in future. As part of her PhD, Dr Hull came up with a questionnaire that attempts to measure masking, which can be used by so-called neurotypicals, as well as diagnosed Autistics, as well as those who suspect they might be Autistic.

Masking, then, is beginning to be more measurable. And there is a lot to this, but initial findings show that while all humans mask sometimes, for a variety of social reasons, Autistic people mask more, and with higher costs to our wellbeing.

My theory is that alcohol is a part of this masking. And one of my most widely shared articles talks about this here:

For masked/undiagnosed neurodivergent people, alcohol often serves as:

• A social lubricant – It quiets the relentless self-monitoring, the fear of saying the wrong thing, the sensory overwhelm of crowded spaces, the agony of small talk about the weather/journey.

• A focus aid – Many with ADHD find that alcohol mimics some effects of stimulant medication, offering temporary relief from racing thoughts. It's like DIY medication but with way worse consequences.

• Something to do with your hands - No idea what to say? Take a sip. Still no clue. Keep sipping!

• A social remote control - Not enjoying the company and/or event and/or environment? Go to the bar and get a round of shots! Still not having fun? Get another round!

• A numbing agent – For Autistic/ADHD individuals, alcohol can dull sensory overload, making the world more manageable. That is, until the hangover kicks in, then suddenly you can hear the molecules in the air vibrating.

• A more tolerable personality – It helps people conform to expected social norms, smoothing out behaviors that might otherwise be deemed “weird” or “intense.” Only for a brief window, though, then your weird/inappropriate self will emerge in force. Watch out for the hangxiety.

Alas, alcohol, effective as it is, is a short-term solution for a long-term issue (a chronic lack of self-acceptance, dripplingly low-self esteem and a prejudiced and intolerant society are not going to be fixed by a perfectly chilled bottle of Sauvignon Blanc, no matter how delicious.)

It also has long-term consequences. The more we use it to manage our differences, the more we distance ourselves from understanding who we really are. Which is unfortunate, because we’re actually pretty interesting once we get past the whole ‘extended existential crisis’ phase.

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The link between late diagnosis and addiction

Studies show a strong correlation between neurodiversity and substance use disorders. One 2021 study found that adults with undiagnosed ADHD were nearly twice as likely to develop alcohol dependence. Autistic adults are also more prone to addiction, often because they turn to substances to manage anxiety, sensory issues, or the exhaustion of masking.

And masking is another thing that neurotypicals often struggle to take seriously. Everyone works hard to fit in, they might say. Everyone gets tired after socialising. But there’s a difference between feeling a bit drained after a party and feeling like you’ve spent two hours doing an intricate performance with no rehearsal. How do you quantify that extra level of effort? How do you explain to someone that, yes, they have to work hard to fit in, but you have to work harder, and that difference - though invisible - is exhausting?

But the real tragedy? So many people aren’t diagnosed until after they hit rock bottom. Many more will never be diagnosed. And even for me, with one of the jolliest rock bottom stories in AA, it is not a fun or glamorous place. There are few heartwarming memories or meaningful milestones checked off your list of hopes and dreams. Just a series of inexplicable decisions and possibly a half-eaten pizza, melting into the gaps between the letters of your laptop keyboard.

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When sobriety leads to self-discovery

A growing number of people are getting diagnosed after they quit drinking. When the crutch is removed, the underlying struggles become more visible: the sensory sensitivities, the executive dysfunction, the deep-seated social anxiety. Many (including me) look back at their drinking years and realise they weren’t just “party animals” or “bad at handling stress” - they were neurodivergent and didn’t know it.

For some, getting sober feels like unlocking the final piece of the puzzle. The same traits that made them prone to addiction - intensity, hyperfocus, sensitivity - become their strengths. They start to create lives that work for their brains, rather than trying to force their brains to fit into the world’s expectations. (And, for the record, the world’s expectations are usually nonsense anyway.)

Sound familiar?

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Rethinking recovery for neurodivergent people

Traditional recovery models don’t always address neurodivergent needs. Many focus on rigid routines, social support groups, and “just try harder” mentalities that can feel alienating. Neurodivergent people often thrive with:

Individualised approaches

Recovery plans tailored to executive function challenges, sensory needs, and social energy levels. (Let’s be real, some of us need recovery plans that involve sitting in a dark room with noise-canceling headphones.) Harm reduction might be more appropriate than abstinence-based programmes for people who need to mask effectively in order to keep their job and pay their rent.

Alternative coping strategies

Sensory-friendly activities, dopamine-friendly hobbies, and medication when appropriate.

Self-compassion

Recognising that past substance use was often a survival strategy, not a personal failure. We were just doing the best we could with the dodgy information we had. This has been a life-changer for me, and for the various friends who have, similarly, been diagnosed after getting sober/clean.

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The way forward

If any of this resonates with you - if you’ve ever wondered why you need that drink at social events, why you struggle with moderation, or why you feel like an outsider in your own life - it might be worth exploring the possibility of neurodivergence.

Getting diagnosed isn’t about labeling yourself; it’s about understanding yourself. And that understanding can change everything.

For many, sobriety isn’t just about quitting alcohol. It’s about finally meeting the person they were always meant to be. Even if that person is still figuring out how to make eye contact without it feeling like an uncomfortable team-building exercise for two unenthusiastic work colleagues.

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More on this subject

The unexplored link between Autism and substance abuse

I drank because I was socially awkward then I got sober and discovered I’m Autistic

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Chelsey Flood is the author of award-winning novels Infinite Sky and Nightwanderers, and a senior lecturer in creative writing at UWE. She is currently working on a book about the connection between undiagnosed neurodiversity and addiction + her first domestic noir